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Canadians are in a kerfuffle over the Trump administration’s preliminary plan to allow Americans to import lower-cost prescription medications from Canada.

The plan was announced July 31 and is part of the administration’s long-sought effort to drag down the US’s skyrocketing drug prices. But it’s a long way from being a reality. Even if the plan does pan out, it will likely be years before regulators review, approve, and scale up efforts to import drugs.

Still, Canadians are infuriated by the idea and already brainstorming ways to toss it down the garburator, according to a report by health-news outlet STAT. Many fear that American importation would exacerbate current drug shortages in Canada.

“You are coming as Americans to poach our drug supply, and I don’t have any polite words for that,” Amir Attaran of the University of Ottawa told STAT. Prof. Attaran went on to refer to the plan as “deplorable” and “atrociously unethical.” “Our drugs are not for you, period.”

Under the Trump administration’s plan, individual states would come up with their own frameworks to safely import drugs and then submit the plans to the federal government for approval. The administration also plans to allow manufacturers to import foreign versions of drugs already approved by the Food and Drug Administration and sell them at lower costs, as Kaiser Health News points out.

Health and Human Services Secretary Alex Azar—who once called the idea of importing drugs from Canada a “gimmick”—said the federal government is now “open for business” on the idea of importing Canadian drugs. In the past, the HHS, FDA, and US drug companies have argued that there was no way to ensure the safety and efficacy of imported drugs. But by the time the administration announced its import plan, Azar said his mind had been changed.

On Monday, August 12, Canada’s Minister of Health Ginette Petitpas Taylor was set to meet with pharmacists, patients, and industry officials to discuss a response to the US plan, according to STAT. Petitpas Taylor has pledged to “ensure there are no adverse effects to the supply or cost of prescription drugs in Canada.”

In order to protect Canadians, some advocates and policy experts suggested that Canada could begin controlling the export of pharmaceuticals, pass new laws simply banning exporting drugs meant for Canadians, or impose new tariffs.

In order to protect Canadians, some advocates and policy experts suggested that Canada could begin controlling the export of pharmaceuticals, pass new laws simply banning exporting drugs meant for Canadians, or impose new tariffs.

Well, yes, that does seem like the obvious and appropriate thirty-second solution.

I'm not sure why the language other implies that Party A can import without Party B exporting. It's not the sort of thing you can do all by your lonesome.

In order to protect Canadians, some advocates and policy experts suggested that Canada could begin controlling the export of pharmaceuticals, pass new laws simply banning exporting drugs meant for Canadians, or impose new tariffs.

Well, yes, that does seem like the obvious and appropriate thirty-second solution.

I'm not sure why the language other implies that Party A can import without Party B exporting. It's not the sort of thing you can do all by your lonesome.

USA: can haz buy cheap Canadian drug?Canada: No

Which will probably piss off Trumpolini so much that he slaps a huge tariff on drugs imported from Canada........

But if Canadian drugs get imported by the same evil middlemen who have inflated the current American drug prices, how will anything change for us ordinary folks? It's not as though Canada is magically manufacturing them cheaper, they just don't have the same sociopaths pulling the strings between consumer and supplier. This feels like an incredibly silly sideshow.

On the surface it makes sense that you would seek a cheaper alternative for medication that is cheaper. But if you make it wholesale policy to raid another countries drug supply, you just turned their drug supply into an extension of yours. And your price controls will almost certainly defacto take over their prices. And as mentioned, limited supply. I can see why Canadians are working to scuttle this.

But how do you terminate this without harming visitors to Canada who honestly need prescription refills while visiting Canada? I have no idea.

Canadian here. Our health system, while far from perfect, is both a source of national pride and a defining characteristic of how we identify as being Canadian. The thought that another country, particularly one that consistently disparages the very idea of socialized medicine, would come in and raid our pantry feels, quite frankly, infuriating.

On the surface it makes sense that you would seek a cheaper alternative for medication that is cheaper. But if you make it wholesale policy to raid another countries drug supply, you just turned their drug supply into an extension of yours. And your price controls will almost certainly defacto take over their prices. And as mentioned, limited supply. I can see why Canadians are working to scuttle this.

But how do you terminate this without harming visitors to Canada who honestly need prescription refills while visiting Canada? I have no idea.

Beth, you missed the best part: the Trump administration published this plan *without even telling Canadian authorities about it*.

Reversing a decades-long policy of claiming Canadian drugs were unsafe (which also rankled Canada's pride, but whatever) on a Monday morning with no warning and not discussing this with Canada at all -- it's completely bonkers.

Canadian here; I know my anecdote isn't evidence, but the recent amount of US traffic into border cities to buy cheap drugs has already had a negative impact. I have a friend who had to go to a few different pharmacies to get diabetic supplies. Most Canadians I know aren't "furious" about this situation, we just want to make sure we have enough for our own citizens at a reasonable price.

Beth, you missed the best part: the Trump administration published this plan *without even telling Canadian authorities about it*.

Reversing a decades-long policy of claiming Canadian drugs were unsafe (which also rankled Canada's pride, but whatever) on a Monday morning with no warning and not discussing this with Canada at all -- it's completely bonkers.

No it's not. The outrage is the point, as his entire administration has shown to this point.

That said: the real question is, what is Trump's dickery concealing? Obviously it has something to do with Canada.

Trump doesn't care a whit about prescription drug prices. This is something to brag about in the election season, and if it doesn't pass regulatory approval, or if the Canadians block it, who cares? The election will be over by then.

On the surface it makes sense that you would seek a cheaper alternative for medication that is cheaper. But if you make it wholesale policy to raid another countries drug supply, you just turned their drug supply into an extension of yours. And your price controls will almost certainly defacto take over their prices. And as mentioned, limited supply. I can see why Canadians are working to scuttle this.

But how do you terminate this without harming visitors to Canada who honestly need prescription refills while visiting Canada? I have no idea.

There isn't a viable business model of sending people to fill one scrip at a time. If you show up to a pharmacy with prescriptions for one person, asking for a reasonable amount of drugs, it's not a problem.

What's a problem is showing up to a warehouse offering to buy truckloads of pills. That would lead to shortages as pharma would decide that instead of shipping pills to Canada and then selling them in the US through a reseller, it would rather not ship to Canada, forcing Americans to buy in the US.

Canada would then be forced to nationalize a bunch of pharma plants and proceed to violate patents out of medical necessity. It might be something that should happen anyway but there's not much support for the idea, and it would risk major sanctions from the US.

Getting medications from Canada to the US is currently a major freakin' pain in the ass. US CBP is virtually guaranteed to destroy or send back any that cross by mail or courier, except for a handful of "approved" distribution channels. A significant number of Americans are already driving across the border on a regular basis, just to use Canadian pharmacies, because you're generally OK if you carry a short-term supply of your *own* prescription meds through US CBP in their original containers. There are some things that are medically necessary and that can only be obtained via grey-market channels, because the FDA simply hasn't got around to dealing with their distribution approval paperwork yet.

That said, if the freakin' FEDERAL GOVERNMENT's answer to "American drugs are obscenely overpriced" is "so why don't you buy them from Canada", we'll happily build the capacity and take some profit in the process (while making sure we protect our own supplies), but you still won't be anywhere near as well off as if you just fixed the problem in the first place. Make it easier to approve and distribute generics, bust up cartel behaviour, allow generic substitution by pharmacists by default unless the physician orders otherwise, ban direct-to-consumer drug marketing, ban drug rep / physician kickback schemes, allow Medicare/Medicaid to negotiate block-buy contracts..... You're America. You're rich and you're full of brilliant people. You can solve this on your own. The other 100+ countries who have solved it will gladly share their "this works, this doesn't" experience, if you ask.

So let me get this straight. We can't seem to find the legislative muscle to make things right in this country, but those same people (sorry GOP) who are the roadblocks will now support importing cheaper drugs? I'm so confused. Is this to maintain their so called "free market" (which is rigged) while also getting the cheap drugs?

. . . Can't Canada just buy more drugs with all the money they get from US States importing drugs? Heck, by pooling Canadian purchases with US purchases, if anything, it gives Canada an even stronger negotiating position with pharma companies, because they just increased their purchase size by 5x what it previously was.

The people complaining about the US coming to take Canada's drugs seem to view the quantity of drugs Canada can purchase as fixed? Is it fixed? Why would it be?

Yes, it's kind of dumb that the best plan Repubs can come up with is, "buy them from a country with socialized medicine that can negotiate resonable prices, because we, the Republicans, won't allow our states or Medicare to negotiate".

Canadian here. Our health system, while far from perfect, is both a source of national pride and a defining characteristic of how we identify as being Canadian. The thought that another country, particularly one that consistently disparages the very idea of socialized medicine, would come in and raid our pantry feels, quite frankly, infuriating.

A Canadian just said "infuriating". For those not familiar, them's fightin' words. Beware the beavers!

A huge problem is that there is almost zero transparency in drug pricing at any level except during dispensing. We know how much a pharmacy will charge to fill, but do we have any idea how much the PBM or distributor charges the pharmacy to supply it, or how much the supplier charges the PBM/distributor? No. This has to change before we can get anywhere.

Beth, you missed the best part: the Trump administration published this plan *without even telling Canadian authorities about it*.

Reversing a decades-long policy of claiming Canadian drugs were unsafe (which also rankled Canada's pride, but whatever) on a Monday morning with no warning and not discussing this with Canada at all -- it's completely bonkers.

No it's not. The outrage is the point, as his entire administration has shown to this point.

That said: the real question is, what is Trump's dickery concealing? Obviously it has something to do with Canada.

The first place I would look is hotels and resorts. Does he have any there? Who would we buy drugs from? Does he have any prior relationship with them? Have they stayed in his hotels? Will they be staying there in the next 6 months like everyone else seems to do?

I believe this is another flashy display by the president to appease people work no real intent of follow through.

The Republican party LIKES Medicare as it currently exists. It forces tax money into mega corporations we with no legal grounds to negotiate. It is a DREAM contact. Imagine your employer saying "put a number on this paycheck you're happy with that won't make a C-level exec question you're employment."

For all the lip service to cutting healthcare, Republicans actually don't want to fully dismantle the system. They want it to continue to support their citizens in need, while also lining the pockets of the big pharma. It's a win win to them.

The real threat is actually fixing the system, they do NOT want a functional system or a system that can reduce the tax dollars drain from government to corporations.

What frosts me as a Canadian is the galling assumption that we're just there to be exploited. He didn't ask, didn't consider our needs, just up and figured that our resources are the US's to use and abuse. I mean, it's not like we're people or anything. If we have it, it's only ours until the US decides it's theirs, eh? The arrogance. Gee, thanks.